Qian et al identified risk factors for biliary complications following liver transplantation. These can help identify a patient who may benefit from closer monitoring post-transplant. The authors are from the University of Hong Kong.


Types of liver transplants:

(1) cadaveric whole liver

(2) cadaveric partial liver (left lobe, right lobe, segments 2 and 3)

(3) liver donor partial liver


Post-transplant biliary complications:

(1) bile leakage (from anastomosis, missed hepatic duct branch, leakage around T-tube, after removal of T-tube)

(2) anastomostic stricture


Risk factors for biliary complications:

(1) preoperative serum bilirubin (risk increases with increasing serum bilirubin level)

(2) biliary anastomosis using a stent or T-tube splinting

(3) use of a live donor liver graft


Mortality associated with biliary leakage may be direct, or indirect "owing to radiological intervention."


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